Radiofrequency induced hyperthermia in non-muscle invasive bladder cancer: Oncologic outcomes in a real-world scenario

Actas urologicas espanolas Pub Date : 2025-06-01 DOI:10.1016/j.acuroe.2025.501746

S. Mero , K. Oberneder , J. Weiss , E. Grobet-Jeandin , A. Grégoris , P. Sèbe , S. Shariat , D. D’Andrea

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Abstract

Objectives

Patients with non-muscle invasive bladder cancer (NMIBC) face a high risk of recurrence and progression after transurethral resection, making adjuvant therapies necessary. Intravesical device-assisted therapies, such as radiofrequency-induced thermochemotherapy (RITE), have shown promise in enhancing the effectiveness of intravesical chemotherapies. This study aimed to evaluate oncological outcomes in patients with NMIBC treated with RITE in a real-world setting, encompassing those unresponsive to prior Bacillus Calmette-Guérin (BCG) or intravesical chemotherapy, as well as those who declined or were ineligible for BCG or radical cystectomy (RC).

Methods

A retrospective multicenter analysis of patients treated with RITE for NMIBC between 2015 and 2024 was performed. Co-primary endpoints of the study were intravesical recurrence free survival (RFS) and high-grade intravesical recurrence free survival (HG-RFS). Secondary endpoints included radical cystectomy-free survival (RC-FS), overall survival (OS), cancer-specific survival (CSS), and adverse events (AEs).

Results

Fifty-nine consecutive patients were included in the final analyses. Overall, 12 (20%) and 45 (76%) patients failed previous intravesical chemotherapy, and immunotherapy with BCG, respectively. The 24-months RFS and HG-RFS following RITE were 68.6% (95% CI: 0.568, 0.828) and 74.8% (95% CI: 0.632, 0.885). RC-FS at 24 months was 93.8% (95% CI: 0.872, 1.000). The OS probability at 24 months was 91%, with a CSS of 97.8%. Most common AEs were dysuria and urgency in 27 (45.7%) patients, treatment limiting bladder spasms in 11 (19%) patients, low bladder compliance in 11 (19%) patients and urethral strictures in 5 (8%) patients.

Conclusion

In our analyses, RITE resulted in notable antitumor activity and allows for the avoidance of more aggressive and quality-of-life-limiting therapies, such as radical cystectomy. RITE might be considered as a second-line bladder-sparing option in patients failing previous intravesical therapies. Long-term follow-up and larger-scale data are required to validate our findings.

查看原文本刊更多论文

射频诱导热疗治疗非肌肉浸润性膀胱癌：现实世界中的肿瘤学结果。

目的：非肌肉浸润性膀胱癌（NMIBC）患者经尿道切除术后复发和进展的风险很高，需要辅助治疗。膀胱内装置辅助治疗，如射频诱导热化疗（RITE），已显示出增强膀胱内化疗有效性的希望。本研究旨在评估在现实环境中接受RITE治疗的NMIBC患者的肿瘤学结果，包括那些先前对卡介苗（BCG）或膀胱化疗无反应的患者，以及那些拒绝或不符合卡介苗或根治性膀胱切除术（RC）的患者。方法：对2015年至2024年间接受RITE治疗的NMIBC患者进行回顾性多中心分析。该研究的共同主要终点是膀胱内无复发生存期（RFS）和高度膀胱内无复发生存期（HG-RFS）。次要终点包括无根治性膀胱切除术生存期（RC-FS）、总生存期（OS）、癌症特异性生存期（CSS）和不良事件（ae）。结果：59例连续患者纳入最终分析。总体而言，分别有12例（20%）和45例（76%）患者在之前的膀胱化疗和卡介苗免疫治疗中失败。RITE后24个月RFS和HG-RFS分别为68.6% （95% CI: 0.568, 0.828）和74.8% （95% CI: 0.632, 0.885）。24个月时RC-FS为93.8% （95% CI: 0.872, 1.000）。24个月时的OS概率为91%，CSS为97.8%。最常见的ae是27例（45.7%）患者的排尿困难和尿急，11例（19%）患者的治疗限制了膀胱痉挛，11例（19%）患者的膀胱依从性低，5例（8%）患者的尿道狭窄。结论：在我们的分析中，RITE产生了显著的抗肿瘤活性，并允许避免更积极和限制生活质量的治疗，如根治性膀胱切除术。对于先前膀胱内治疗失败的患者，RITE可能被认为是保留膀胱的二线选择。需要长期随访和更大规模的数据来验证我们的发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Actas urologicas espanolas

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